Chemo Worksheets

Keep track of important phone numbers, treatment history, chemo side effects, and laboratory results, such as your complete blood count (CBC) or the medicines you are taking. Knowing these may help you to understand and manage your care.

Use these worksheets to help organize this information so you can be an active participant in your cancer care.

Your healthcare team is your best source of information. To make sure you get the answers you deserve about your disease, your treatment, possible risks, and the best protection, it's important to find out as much as you can by reading, learning, and asking. This list will help you get started understanding what questions might come up. When you have a question, write it down and save it for the next time you talk to your doctor.

Store contact information for your doctor, caregivers, nutritionist, and other members of your healthcare team as well as the people who are supporting you in other ways during your chemotherapy (chemo).

To get the most from your chemo, you and your healthcare team must work together to determine the best medication, dose, and schedule for your specific condition. You may be taking multiple medications, and when combined with one or more other medications, any medication can produce additional effects beyond those intended. Keep accurate records of your doctor visits. Write down the questions you ask and the answers you get.

Make a list of persons willing to help in case you need it. This worksheet gives you a place to write down names and contact information, task involved, and dates or times of participation. This can help you stay organized during chemo. You can give copies of the list to key people like family members and caregivers.

You will speak to many providers during your time in chemo. This document helps you keep track of your tumor type, stage or grade, surgical history and treatments, plus any medications you are taking. Bring this planner with you; so that you can accurately relate your health history.

Medical insurance and bill management can be frustrating. Most hospitals and clinics provide a patient services representative to assist you with such issues. You can keep track of and record the results of these conversations in the Insurance Discussion Record.

A change in a person's condition caused by taking a medication, using a medical device, or through another type of treatment.

A test that determines the number of red blood cells, white blood cells, and platelets in a blood sample.

A mass of tissue made up of abnormal cells. Tumors can be malignant (cancer) or benign (not cancer).

The extent or severity of a cancer. The stage is determined after performing tests, which may include physical exams, lab tests, x-rays, CT/CAT scans, and sometimes surgery. Some of the important factors for determining stage are the size of a tumor, whether lymph nodes contain cancer, and whether the disease has spread.

Grade is the measurement of a cancer, reflecting how abnormal the cells look under a microscope. There are several grading systems for cancer, but grades are commonly divided into 4 grades:

Least abnormality (grade 1 or well differentiated)

Intermediate features (grade 2 or moderately differentiated)

Greatest abnormality (grade 3 or 4 or poorly differentiated)

A specialist called a pathologist performs the grading by examining the biopsy specimen. Knowing the grade is important. A cancer's nuclear grade is based on features of the central part of its cells, the nucleus. The histologic grade refers to how much the tumor cells resemble normal cells of the same type of tissue.

a test that determines the number of red blood cells, white blood cells, and platelets in a blood sample.